Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.20 / $67.03 / $67.03	Facility	26	$53.20	$67.03	$67.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $257.80 / $436.57	Professional		$206.63	$257.80	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $53.20 / $83.27	Professional	26	$42.69	$53.20	$83.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.80 / $215.11 / $366.55	Professional	TC	$151.80	$215.11	$366.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $44.18 / $66.27	Professional	26	$34.54	$44.18	$66.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $363.33 / $516.30	Professional		$66.73	$363.33	$516.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.66 / $71.37 / $71.37	Professional	26	$60.66	$71.37	$71.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.01 / $338.68 / $750.03	Professional		$240.01	$338.68	$750.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $55.74 / $131.69	Professional	26	$44.72	$55.74	$131.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.77 / $283.16 / $615.99	Professional	TC	$201.77	$283.16	$615.99
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.50 / $53.20 / $67.03	Facility	26	$45.50	$53.20	$67.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $206.64 / $318.70 / $455.85	Professional		$206.64	$318.70	$455.85
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.32 / $79.63	Professional	26	$44.14	$52.32	$79.63
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $169.96 / $269.39 / $393.96	Professional	TC	$169.96	$269.39	$393.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $222.47 / $336.19	Professional		$36.43	$222.47	$336.19
United Facility/Professional Professional Modifier Low / Median / High Price $257.30 / $323.75 / $448.80	Professional		$257.30	$323.75	$448.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.26 / $54.21 / $81.04	Professional	26	$45.26	$54.21	$81.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.79 / $271.37 / $383.34	Professional	TC	$223.79	$271.37	$383.34